Central California Alliance for Health | Living Healthy | March 2020

7 HEALTHY As an Alliance member, you should not have to pay for covered services unless you: ● Have a Medi-Cal Share of Cost ● Are an Alliance Care IHSS member receiving a service that has a co-payment ● Go to a provider that doesn’t take Alliance insurance, but you tell the provider you want to be seen there anyway and that you will pay for the services yourself ● Have Medicare and Medi-Cal and: ■ You are paying your Medicare drug co-payment. ■ You choose to see a doctor that doesn’t accept Medi-Cal as your secondary insurance. But there may be times when you get a bill. Don’t ignore it. Follow these steps: 1. Call the phone number on the bill and ask why they sent it to you. They might not know what insurance you have. 2. If you were eligible with the Alliance when you got the services, tell the provider you were an Alliance member and give them your Alliance ID number. You will find this on your Alliance ID card. 3. Ask the provider to bill us for the service(s). If you have done this but keep getting a bill, call Member Services at 800-700-3874 . Make sure you have: ● Your Alliance ID number ● The name and phone number of the provider billing you ● The account number on the bill ● Information about the service(s) you received and the date(s) you received them What to do if you get a bill ● The amount of the bill We may not be able to help you if you don’t have this information. We also cannot help you with a bill that is more than one year old. If you have other health insurance: In most cases, your other health insurance is the primary insurance. This means that the provider bills the other insurance before billing the Alliance. If you get a bill and have other health insurance, check to make sure the provider billed your other health insurance first. If you get retroactive Medi-Cal: Medi-Cal beneficiaries sometimes become eligible for medical services after they receive them. The eligibility can go back to cover the services that were provided. This is called retroactive eligibility. If you are an Alliance Medi-Cal member who received retroactive eligibility, it is your responsibility to tell the provider you now have Medi-Cal. The provider will have to bill state Medi-Cal for the retroactive period, not the Alliance. Give the provider your ID number on your Medi-Cal Benefits Identification Card (BIC) so they can bill the state for the services. WRITTEN LETTERS AND NOTICES that affect your health care coverage are also offered in your language. We can also help you read these documents if you speak a language other than English.